Answers
mammogram screening Correct Answer: ACOG - 1x yr
@ 50
Pap smear Correct Answer: age 21 - 65 --> 21 - 30 q3yr,
30-65 q5yr
Pt with history of first degree relative with breast cancer -
how to proceed? Correct Answer: offer mammogram @
40 yrs.
Screening for GI cancer? Correct Answer: colonoscopy
@ 50 yrs and if normal, repeat every 10 years.
Sigmoidoscopy is also acceptable @ 50 yrs but repeat is
every 5 years.
Most effective form of birth control? Correct Answer:
Depo-Provera, IUD, Sterilization these carry a <1%
chance of pregnancy whereas oral contraceptives are
3-5%
,At what age is a DEXA scan indicated for prevention?
Correct Answer: 65 years, unless they have a preexisting
risk factor which warrants earlier screening.
What are risk factors for osteoporosis? Correct Answer:
menopause, glucocorticoid therapy, sedentary lifestyle,
alcohol consumption, hyperthyroidism,
hyperparathyroidism, anticonvulsant therapy, vitamin D
deficiency, family history of early or severe osteoporosis
and CHRONIC liver or renal disease.
What vaccines are contraindicated during pregnancy?
Correct Answer: MMR and Varicella
what vaccines are safe to give during pregnancy?
Correct Answer: Tetanus, Hep B, Polio, Pneumococcal
Pt is 24 and considering pregnancy - what
recommendations can be made with regard to folate
consumption? Correct Answer: folate supplementation is
recommended - fewer nonfatal MIs and fatal coronary
events in women with adequate intake of folate and vit
B6. Studies have shown that folate in diet alone is not
effective in achieving adequate levels. Levels are
,especially important prior to pregnancy and during the
first four weeks of fetal development. (remember that
folate lowers homocysteine levels)
Pregnant female @ 28 weeks --> Hgb dropped from 12.3
to 10.6 from baseline. MCV is 88 w/o additional labs or
symptoms. Whats most likely cause? Correct Answer:
relative hemodilution of pregnancy --> maternal blood
volume increases roughly 36% with max being reached
@ 34 weeks.
Physiologic dyspnea of pregnancy Correct Answer:
presents in up to 75% of women by third trimester
PFT changes during pregnancy Correct Answer:
Inspiratory capacity --> INCREASE
Tidal volume --> INCREASE
Minute ventilation --> INCREASE
FRC --> DECREASE
ERC --> DECREASE
RV --> DECREASE
, Acid base status of normal pt during pregnancy?
Correct Answer: respiratory alkalosis --> The respiratory
rate does not change during pregnancy, but the TV is
increased which increases the minute ventilation which
is responsible for the resp. alkalosis seen in pregnancy.
Pt who is 34 wks gestation develops SOB with normal
vitals --> most likely reason? Correct Answer: Normal
physiologic changes during pregnancy --> IC, TV, MV all
increase whereas RV, ERC, FRC all decrease.
What occurs to plasma osmolarity during pregnancy?
Correct Answer: decreases 2/2 increased maternal
blood volume. This decrease in plasma osmolarity
increases the pts susceptibility to pulmonary edema.
what are common causes of pulmonary edema in
pregnancy? Correct Answer: 1. Tocolytic use
2. Cardiac disease - peripartum cardiomyopathy
3. Fluid overload
4. Preeclampsia